非精神科 지료에 있어서의 Somatoform Disorder : 그 임상양상과 치료적 접근 it's Clinical Features and Therapeutic Approach

이만홍 최신의학사 1983 最新醫學 Vol.26 No.7

축약형 월경전기평가서 표준화 연구 및 인터넷상에서 적용 가능성

이만홍,김지웅,이정현,김덕만 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.1

연구의 목적 : 연구의 목적은 축약형 월경 전기 평가서(Shortened Premenstrual Assessment Form: SPAF)의 신뢰도 및 타당도를 알아보고, 인터넷상에서의 적용 가능성을 알아보기 위하여 시행되었다. 방 법 : 월경전 불쾌장애 환자 28명과 월경 전 불쾌장애에 해당하지 않는 가임 연령의 여자 연구 대상자 27명을 대상으로 세브란스 여성 정신 건강 특수 클리닉 홈페이지를 통하여 축약형 월경전기평가를 시행하게끔 하였다. 월경전 불쾌장애의 진단은 2개월간의 전향적인 평가를 통해 내려졌다. 결 과 : 축약형 월경전기 평가서는 정동요인, 통증 요인, 수분 저류 요인으로 구성되어 있으며, 검사-재검사 신뢰도는 0.80으로 우수하였다. 내적 일치도(Cronbach alpha) 또한 0.91로 우수하였으며, 월경전기평가서 점수와 축약형 월경전기 평가서의 상관계수는 0.92로 나타났다. 월경 전 불쾌장애 환자군과 월경전 불쾌장애에 해당하지 않는 연구 대상군 사이의 축약형 월경정기평가서 점수도 유의한 차이가 있었고(t=5.57, p<0.001), 판별 분석상에서 축약형 월경전기 평가서 점수가 두 집단을 잘 판별할 수 있는 것으로 나타났다(eigenvalue : 0.60, canonical correlation coefficiency : 0.61, Wilk's lamnda : 0.63). 두 집단을 구분하는 최적 절단점은 27점으로 추정되었고, 이때의 민감도(75%)와 특이도 76.9%)는 비교적 우수한 것으로 나타났다. 결 론 : 이상의 결과들을 종합할 때, 축약형 월경전기 평가서는 신뢰도 및 타당도가 우수한 월경전기증상 평가 도구로서 인터넷상에서도 유용하게 사용될 수 있는 도구임이 시사된다. Objectives : The purposes of this study are to investigate the reliability and validity of shortened premenstrual assessment form and the applicability to internet interface. Method : The total of 55 subjects were included in this study. Among them, 28 subjects had premenstrual dysphoric disorder, and the other 27 subjects did not. All subjects performed the shortened premenstrual assessment form through internet interface in the homepage of Severance Woman Clinic. The diagnosis of premenstrual dysphoric disorder was determined by prospective assessment for 2 months. Results : The shortened premenstrual assessment form consists of 3 factors : affect, pain and water retention. The test-retest reliability of this scale was 0.80, and internal consistency(Cronbach alpha) was 0.91. The correlation coeffeciecy between scores of the premenstrual assessment form and the shortened premenstrual assessment form was 0.92. The difference of the scores of the shortened premenstrual assessment form between the group of premenstrual dysphoric disorder and the group of non-premenstrual dysphoric disorder was significant(t=5.57, p<0.001). Discriminant analysis also revealed that the shortened premenstrual assessment form was useful to differentiate between premenstrual dysphoric disorder and non-premenstrual dysphoric disorder(eigenvalue : 0.60, canonical correlation coefficiency : 0.61, Wilk's lambda : 0.63). The cut-off point to differentiate between two groups was 27, and sensitivity(75.0%) and specificity(76.9%) of this scale for premenstrual dysphoric disorder was acceptable. Conclusion : In summary, the shortened premenstrual assessment form appeared to be reliable and valid for the assesment of premenstrual dysphoric disorder. And the results of this study also suggest that the shortened premenstrual assessment form is a useful tool for internet interface application.

Sertraline의 항우울 효과

이만홍,이범용 中央醫學社 1992 中央醫學 Vol.57 No.12

The authors conducted a open-trial clinical study to evaluate the efficacy of sertraline, a new selective serotonin reuptake inhibitor, with 30 patients with either DSM-III-k diagnosis of major depression or dysthymic disorder and the results were as follows. 1. Symptoms of depression meassured by Clinical Global Assessment Scales, Hospital Anxiety and Depression Scale improved statistically very significantly with 6 weeks of medication. 2. Somatic symptoms complained by patients also improved with 6 weeks of medication. 3. Sertraline showed very little side effects and all of the patients tolerated very well during the six weeks of study period.

축약형 월경전기평가서 표준화 연구 및 인터넷상에서의 적용 가능성

이만홍,김지웅,이정현,김덕만 대한신경정신의학회 2002 신경정신의학 Vol.41 No.1

연구목적: 연구의 목적은 축약형 월경 전기 평가서(Shortened Premenstrual Assessment Form:SPAF)의 신뢰도 및 타당도를 알아보고, 인터넷상에서의 적용 가능성을 알아보기 위하여 시행되었다. 방 법: 월경전 불쾌장애 환자 28명과 월경전 불쾌장애에 해당하지 않는 가임 연령의 여자 연구 대상자 27명을 대상 으로 세브란스 여성 정신 건강 특수 클리닉 홈페이지를 통하여 축약형 월경전기평가를 시행하게끔 하였다. 월경 전 불쾌장애의 진단은 2개월간의 전향적인 평가를 통해 내려졌다. 결 과: 축약형 월경전기평가서는 정동요인, 통증 요인, 수분 저류 요인으로 구성되어 있으며, 검사-재검사 신뢰도는 0.80으로 우수하였다. 내적 일치도(Cronbach alpha) 또한 0.91로 우수하였으며, 월경전기평가서 점수와 축약 형 월경전기 평가서의 상관계수는 0.92로 나타났다. 월경전 불쾌장애 환자군과 월경전 불쾌장애에 해당하지 않는 연구 대상군 사이의 축약형 월경정기평가서 점 수도 유의한 차이가 있었고(t=5.57, p<0.001), 판별 분석상에서 축약형 월경전기 평가서 점수가 두 집단을 잘 판별할 수 있는 것으로 나타났다(eigenvalue:0.60, canonical correlation coefficiency:0.61, Wilk’s lambda:0.63). 두 집단을 구분하는 최적 절단점은 27점으로 추정되었고, 이때의 민감도(75%)와 특이도(76. 9%)는 비교적 우수한 것으로 나타났다. 결 론: 이상의 결과들을 종합할 때, 축약형 월경전기평가서는 신뢰도 및 타당도가 우수한 월경전기증상 평가 도구로 서 인터넷상에서도 유용하게 사용될 수 있는 도구임이 시사된다. Objectives:The purposes of this study are to investigate the reliability and validity of shortened premenstrual assessment form and the applicability to internet interface. Method:The total of 55 subjects were included in this study. Among them, 28 subjects had premenstrual dysphoric disorder, and the other 27 subjects did not. All subjects performed the shortened premenstrual assessment form through internet interface in the homepage of Severance Woman Clinic. The diagnosis of premenstrual dysphoric disorder was determined by prospective assessment for 2 months. Results:The shortened premenstrual assessment form consists of 3 factors:affect, pain and water retention. The test-retest reliability of this scale was 0.80, and internal consistency(Cronbach alpha) was 0.91. The correlation coeffeciecy between scores of the premenstrual assessment form and the shortened premenstrual assessment form was 0.92. The difference of the scores of the shortened premenstrual assessment form between the group of premenstrual dysphoric disorder and the group of non-premenstrual dysphoric disorder was significant( t=5.57, p<0.001). Discriminant analysis also revealed that the shortened premenstrual assessment form was useful to differentiate between premenstrual dysyphoric disorder and non-premenstrual dysphoric disorder(eigenvalue:0.60, canonical correlation coefficiency:0.61, Wilk’s lambda:0.63). The cut-off point to differentiate between two groups was 27, and sensitivity(75.0%) and specificity( 76.9%) of this scale for premenstrual dysphoric disorder was acceptable. Conclusion:In summary, the shortened premenstrual assessment form appeared to be reliable and valid for the assesment of premenstrual dysphoric disorder. And the results of this study also suggest that the shortened premenstrual assessment form is a useful tool for internet interface application.

우울증과 목회상담(I, II)

이만홍 연세대학교 신과대학·연합신학대학원 1999 연세 목회전문화 세미나 Vol.1 No.-

특집 : 우울해 죽겠어요: 현대인과 우울증

이만홍 기독교대한성결교회 활천사 2008 활천 Vol.654 No.-

정신과 병실의 치료환경에 대한 평가-( I ) 병실환경 평가척도의 신뢰도 검사 및 몇가지 변인에 관한 고찰

이만홍,신정호,박정주,임경호 대한신경정신의학회 1985 신경정신의학 Vol.24 No.2

The importance of milieu characteristics in inpatient psychiatric treatment programs has been widely recognized and a number of instruments has been developed to measure these milieu characteristics. Among these instruments, the Ward Atmosphere Scale (WAS), which was developed by Dr. Moos and his colleagues in the Social Ecology Laboratory at Stanford University, is one of the most widely used and the most reliable test to assess the social environment of hospital-based psychiatric treatment programs. As it contains characteristics of culture and value systems of the background society which the psychiatric ward is belonged to, it is necessary to assess reliability and applicability of the instrument again before we use generally in clinical application in a different culture. For this reason, the authors administered the Ward Atmosphere Scale to 291 subiects including patients, students and staff from three different psychiatric inpatient wards: Custodial ward(UUW), Medically oriented ward (MOW) and the authors. Therapeutic community (TCW) to assess the reliability of WAS and it’s stability with consideration of several variables. The results were as follows: 1. The WAS is considered to be a reliable test with moderate to substial interal consistencies of item-total and subscale-total in most :cases, and with low subscale-subscale intercorrelations. However, some of item-subscale internal consistencies dropped to the low level of 0.3,suggesting that the revision of several related items w ill be inevitable. 2. From the result of one-way ANOVA, the WAS showed large significant differences between subiects* perceptions by different therapeutic milieu typology (CUW, MOW, TCW) and by different subjects,status (staff, student, patient), but the evidence indicated that these perceptions are not dependent on several background characteristics such as age, sex and admission (working) days.

치료적 공동사회의 치료전귀에 관한연구 ᅳ ( I I )치료적 공동사회와 일 의학적 정신과 병등에서의 비교연구 ᅳ

이만홍,한정옥,신동범,이충순,정영기 대한신경정신의학회 1984 신경정신의학 Vol.23 No.2

The authors organized and has deen operating a MIXED therapeutic milieu in an university hospital since 1981, which is structurally modified one and is including heterogenous patient subgroups of various diagnositc entities. Based on this experience, the authors has been performing a series of treatment outcome study of this modified therapeutic community. This paper is the second one of the series; a comparison study of outcome between 131 patients who were treated in our therapeutic community ward (TCW) and 124 patients who were treated in a medically oriented ward (MOW). In this study, only the patients of five major diagnostic entities were included; acute functional psychoses (AFP), schizophrenia (SPR), manic disorders (MD), neurotic disorders (ND) and borderline patients (BP), and their outcomes were evaluated by measuring discharge rate of signing out against medical advice (AMA%), drop-out rate of follow-up treatm ent and the Psychiatric Inpatient Assessment Scale (PIAS) which was developed by the authors. The results were as follows: 1. The treatm ent outcomes of both neurotic disorders and borderline patient subgroups were significantly superior in TCW to those of MOW in terms of lower AMA per cent, lower drop-out rate and higher PIAS scores. 2. As for both of acute functional psychoses and manic disorders, the treatm ent outcomes seemed to be inferior in TCW to those of MOW w ith higher AMA per cent, higher drop-out rate but no significant difference of PIAS scores between two wards However the only exception is higher D-score for manic disorder in TCW. 3. Of the schizophrenic subgroup, the outcome can be evaluated to be superior in TCW than in MOW w ith higher D-score and lower AMA.% and drop-out rate significantly, but the author failed to find any significant difference on other PIAS scores, this will need further controlled study and discussion. 4. These findings generally seemed to be complimentary and not incongruent with the results of our previous study of the series.

한국인의 자살기도와 그 사회문화적 특성 : 일부 강원지역을 중심으로 한 정신역동적 고찰 A Psychodynamic Approach in Kangwon District

이만홍,이성훈,신동범 최신의학사 1982 最新醫學 Vol.25 No.8

공황장애

이만홍 약업신문사 1998 의약정보 Vol.1998 No.5